LIP FILLERS - ADDING VOLUME & DEFINITION - Plastic Surgery Dubai UAE

LIP FILLERS -
ADDING VOLUME &
       DEFINITION

If you feel conscious of your lip size, or would like to have more luscious
volume, lip filler injections can provide spectacular results. Hyaluronic
acid is naturally produced in the human body, and micro-injections in the
lip can enhance volume and hydration.

Fillers are typically used to increase the volume and size of the lips.
Collagen or hyaluronic acid-based filler are typical. Collagen works
by plumping, while hyaluronic acid works by both plumping but also
holding water within the lip for a more natural effect. Lip fillers are not
permanent. They last about three months to a year depending on how
quickly your body breaks them down. The type I recommend are made
of hyaluronic acid — a sugar, found naturally in the body, that adds
temporary volume and definition when injected into lips.

The lips can sometimes tend to be uneven with the top or bottom one
thicker than they should be. To get a perfect pout the top lip should be
one third and the bottom lip should be two thirds. Sometimes they are
also larger on one side than the other and the lips are a little lopsided.
Dermal filler can even this out

The objective in treating the upper lip is to artistically create a form
that harmonizes with the patient’s unique facial features and takes
into account the age and ethnic background of the patient. The goal in
treating the lower lip is to create bulk and greater prominence and artistic

© Dr Matteo Vigo                                            Fillers in Dubai

projection of the vermilion. The physician must establish appropriate
guidelines and patient expectations for augmentation relative to normal
lip proportions in order to avoid a cartoon-like appearance.

It’s important to see your box of injectables opened in front of you
and to be sure only your dermatologist or plastic surgeon is doing the
injections. Avoid blood thinners, like aspirin and fish oil, for at least a
day beforehand, which can increase bruising. If you opt for numbing
cream, expect it to be placed on the lips for approximately 10 minutes.
The lips absorb quickly and do not require lengthy topical anaesthesia.
Then, the skin surface should be cleansed properly and then injections
are performed. Your doctor should go very slowly, often pausing to show
you the progress that he or she is making. There is a real balance and art
to it, I find that you really need to go little by little, so you normally inject
the top lip first, balance it out on the other side, then inject the bottom
lip. It takes about 15 to 20 minutes. What you see is what you get, you’re
not waiting for it to work, like Botox.

Some doctors will gently mould the filler with their fingers after it is
injected by squeezing and patting it into place, while others aim to inject
it exactly where they want it and avoid moulding, since it can increase
bruising and swelling. Based on my extensive experience, there is no
single stance on moulding - it’s a technique that some like, while others
do it sparingly.

FILLER SUITABILITY
When selecting a suitable filler for the lips, the following factors are
taken into consideration:

Longevity: it is important to advise the patient how long a product is
expected to last for, and explain that this is not guaranteed in order to
successfully manage their expectations

Crosslinking technology: relates to longevity and propensity to swell
Cost: patient needs to be aware of financial commitment
Company support: specific product knowledge and training/marketing
is essential

© Dr Matteo Vigo                                                Fillers in Dubai

Reversibility: ensures a safety net incase of vascular accident or other
filler-associated complications; you should have an emergency kit
including hyaluronidase on site

Strong clinical study evidence: ensures a safe, evidence-based choice

Previous patient experience of product: if a patient has had good
clinical results with a certain product and is happy with it, do not use
something else as they may be unhappy with the new product

LIP AUGMENTATION TECHNIQUES
There is no single technique that fits every lip, and each practitioner will
have his or her own approach to treatment. Below are the factors of
which typically followed when it comes to lip augmentation:

Visually assess the lip in 3D: i.e. the lateral and frontal view. This will give
an idea of projection required. For an attractive lip, the upper lip should
project around 2mm further than the lower lip.

Assess the smile: if the patient has a ‘gummy’ smile and the lip disappears
upon smiling then consider botulinum toxin injections to soften the
action of the lip elevators. I have found that for best results, it should be
a deep injection, 1cm lateral to the lateral alar of the nose. If the patient
has an active depressor angulioris, contributing to a downturned mouth,
also consider treating this muscle with botulinum toxin to prevent a
downward pull of muscle on the corners of the mouth.

Determine the amount of filler: I always agree with the patient the
amount of filler that will be used. It is important to not over or underfill
the lip (amount is case dependent). For example, overfilling the upper
lip can create a ‘duck lip’ appearance, which is usually not regarded as
aesthetically appealing. I do not use more than 1ml per visit to prevent
overcorrection and reduce the risk of vascular compression.

Enhancement or restoration: I always ask if the patient is seeking
enhancement or restoration – this usually depends on the patient’s age –
to ensure that you understand their expectations of treatment.

Age appropriateness: ensure that the lips are ‘age appropriate’. I advise
not to try to create the lips of a 25 year old on a 60-year-old patient.

© Dr Matteo Vigo                                               Fillers in Dubai

In patients showing signs of ageing: treat the perioral complex and not
just the lip. To do this, use filler to turn up the corners of the mouth
at the oral commissure, to treat oral rhytids and to restore volume in
the cutaneous lip and chin area. Botulinum toxin in the mentalis and
depressor angular oris can be used to reduce hyperkinetic activity of
mouth depressors.

Consider the vermillion border: consider using low viscosity filler when
treating the vermillion border. This can create a very sharp and well-
defined demarcation by creating maximum light reflection without
distorting the delicate lip architecture.

POST-INJECTION CARE
Cool compresses and ice packs can be used to minimize swelling and
bruising. Patients should be advised to avoid ASA, NSAIDs, and other
medications associated with an increased risk of bleeding. If anti-HSV
I medication was prescribed, it should be continued according to
physician recommendation. Because HAs are hydrophilic, they attract
water from the surrounding tissues and further augment the soft tissue
volume beyond that expected from mere implantation. The significant
swelling of the vermilion in the immediate post-operative period may
be camouflaged by applying flesh-toned foundation or concealer to the
entire vermilion. Lipstick can then be applied to a smaller portion of the
vermilion than usual so as to not exaggerate the swelling that may be
present.

SELECTING THE RIGHT FILLER
There are a lot of difficult decisions you have to make when it comes
to getting lip injections, but fortunately, picking the right filler isn’t one
of them. Hyaluronic acid, in a few different forms, is both the industry
standard for temporary lip injections and the only temporary lip filler
approved by the FDA.

They’re marketed under different brand names - Restylane Silk, Belotero,
Juvederm - but they’re all made from the same molecule, which is

© Dr Matteo Vigo                                              Fillers in Dubai

hyaluronic acid, as you may already know, naturally occurs in skin and
is a top ingredient in hydrating skin-care products, since it plumps skin
by capturing and holding onto water. Picking which of the formulas is
best for you is really up to your doctor. Hyaluronic acid is not only the
best option, but the only option for those new to the world of injections,
since it will dissolve on its own and is well-tolerated, since it’s already in
your body. There are irreversible fillers and implants, but those are not
for beginners.

PAIN MANAGEMENT
Lips are one of the more uncomfortable places to inject filler. We have
a lot of nerves in our lips, so I can do a combination of topical numbing
cream and, sometimes, injectable numbing medications, so patients are
comfortable. However, many of the H.A. injectables come with lidocaine
(a numbing pain reliever) built right in, so some doctors opt out of
additional measures. One, or a combination of the above pain-reducing
options, will normally temper the pain of the actual procedure, but you’re
likely to experience pain later, since the skin is being stretched. The pain
as mild to moderate and notes that it can last for a few days.

SIDE EFFECTS
Any time there is a needle crossing the skin, there is a risk. Bruising,
swelling, and pain - all of which can last up to days and in rare cases,
even weeks - may occur. There is also the risk of infection. Naturally, this
makes it very important to check in with your doctor post-treatment,
especially if you’re feeling nervous about side effects.

While hyaluronic acid is a naturally occurring substance in your body,
you can still have an allergic reaction to H.A. injectables, since there
are often inactive ingredients (like carrying agents) and pain-reducing
ingredients (like lidocaine) in the formula. Those prone to allergies or are
just plain nervous can do a patch test on their forearm a few days before
the procedure to be sure they won’t have an adverse reaction.

© Dr Matteo Vigo                                              Fillers in Dubai

Injecting the lips can prompt cold sores for those who are prone to
them, so he normally pretreats those patients with a round of anti-viral
medication, like Valtrex.

There are also less common side effects that are important to consider.
More rare side effects include nodules or palpable material within the
lips - basically bumps of H.A. that don’t settle or feel natural. Extremely
rarely, lip filler can be introduced into a blood vessel in the lip, which can
have more significant consequences if not dealt with immediately and
appropriately.

WHAT TO EXPECT
One of the great things about lip injections is that the results are
instantaneous, so you’ll leave the office with fairly accurate (albeit
swollen) results. For the first 24 to 48 hours, the filler is malleable and
your skin is prone to swelling, which means be gentle! This is noted as
the time that your injections need to “settle.” No facials, yoga, or exercise
is recommended, which can alter the placement of the filler and increase
swelling and bruising.

Lips often swell for one to three days after treatment, but this is highly
variable and some patients will experience no swelling and some will
have more dramatic swelling that will take longer to subside. Bruising
can last approximately one week, but can be covered with makeup or
lipstick, as needed. Some doctors will offer to treat more significant
bruising with a laser treatment if necessary.

© Dr Matteo Vigo                                              Fillers in Dubai

A brief note from
     Dr Matteo Vigo

© Dr Matteo Vigo   Fillers in Dubai

I decided to become a doctor at early age but I was not aware
    of the world of Plastic Surgery. Once I have discovered it I fell
    in love with the whole concept behind and how this field of
    Medicine can be helpful for many people.

    I passionately believe that, in order to improve the physical
    aspect of a patient, the plastic surgeon needs to combine the
    principles of art and science, adopting a global approach to
    understanding the individual desires.

    Plastic Surgery is a truly fascinating, dynamic, constantly
    evolving field of medicine and I believe that the role of a
    Cosmetic Surgeon is unique and highly privileged.

    My main goal is to understand the needs of a patient and
    try to transform their desires into reality. The role of a plastic
    surgeon is not only merely surgical but also supportive in
    the decision process of the best treatment to help patients
    finding theirselves and their wellbeing.

    All these steps are taken into consideration once a person
    walks in my office and the service I am offering them is always
    at the top.

    I am combining experience, quality and professionality to
    evaluate each single case and offer the best solution for my
    patients.

    “Because you deserve the best” is my motto and I want
    always to put the patient at the centre of what I am doing.

    You have to feel pampered, understood, listened, loved once
    in my office and the feedback of this feelings from my patient
    is my best satisfaction.

    Dr Matteo Vigo

© Dr Matteo Vigo                                           Fillers in Dubai

LIP FILLERS
DUBAI

To book a consultation with
Dr Vigo, please contact us today.

EMAIL
booking@matteovigo.com

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+971 56 282 5825

Locations

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Building P11
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Dubai

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Al Wasl Road, Verve Villas
Umm Al Sheif
Dubai

ESTELAZA CLINIC
Silicon Oasis, Nibras Oasis 2
Dubai

© Dr Matteo Vigo                    Fillers in Dubai